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Baloch SS, Khan SR, Tariq M, Wasio A, Ali AA, Shahzadi M, Moosajee M, Anwar S, Raza A, Uddin S. Multiple myeloma and its rare paraneoplastic manifestations simmering under the surface. Pathol Res Pract 2023; 248:154689. [PMID: 37478520 DOI: 10.1016/j.prp.2023.154689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/11/2023] [Accepted: 07/13/2023] [Indexed: 07/23/2023]
Abstract
Paraneoplastic syndromes are complex clinical manifestations that occur because of the underlying malignancy in which the malignant cells produce hormones, cytokines, peptides or antibodies that causes symptoms and may affect multiple organ systems. These paraneoplastic conditions may be associated with different solid and hematological malignancies. Multiple Myeloma (MM) accounts for 10-15 % of hematological malignancies and 1-2 % of all malignancies. It is associated with some atypical clinical and laboratory paraneoplastic manifestations. Although there is a low incidence of these paraneoplastic, significant knowledge of these manifestations may assist in making a differential diagnosis in cases of doubt. The clinical presentation may vary and be evident even before or after the diagnosis of malignancy. These include vascular, neurological, dermatological, physiological, and other atypical conditions. Furthermore, these rare paraneoplastic manifestations need more valid, relevant scientific information, as most information about these conditions is derived from case reports. After the literature search, we have reported the paraneoplastic manifestations associated with multiple myeloma, published in the English literature, and the cognate management in this review article. To our knowledge, this is the first review article discussing various paraneoplastic manifestations of multiple myeloma.
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Affiliation(s)
| | - Saqib Raza Khan
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan.
| | - Muhammad Tariq
- Department of Medical Oncology, Khyber Teaching Hospital, Peshawar, Pakistan
| | - Abdul Wasio
- Department of Medicine, Carney Hospital, Massachusetts, USA
| | - Ayesha Arshad Ali
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Mehwish Shahzadi
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Munira Moosajee
- Department of Medical Oncology, Aga Khan University Hospital, Karachi, Pakistan
| | - Shaheena Anwar
- Department of Biosciences, Salim Habib University, Karachi, Pakistan
| | - Afsheen Raza
- Department of Biomedical Sciences, College of Health Sciences, Abu Dhabi University, the United Arab Emirates
| | - Shahab Uddin
- Translational Research Institute, Dermatology Institute, Academic Health System, Hamad Medical Corporation, Doha, the State of Qatar; Laboratory Animal Research Center, Qatar University, Doha, the State of Qatar.
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2
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Paul P, Walker CP, Paul M, Dey D. Sweet's Syndrome in a Patient With Seropositive Rheumatoid Arthritis After Starting Adalimumab: Is Sweet's Syndrome Related to Rheumatoid Arthritis or Is It the Paradoxical Effect of Adalimumab? Cureus 2021; 13:e16804. [PMID: 34513410 PMCID: PMC8407047 DOI: 10.7759/cureus.16804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2021] [Indexed: 01/15/2023] Open
Abstract
Sweet’s syndrome is a rare acute febrile neutrophilic dermatosis accompanied by fever, neutrophilia, and asymmetrical distribution of tender erythematous skin lesions. The underlying biological pathways responsible for this inflammatory skin disorder are not yet clearly established. However, an association with autoimmune disease, neoplasm, and drugs could be indicative of unusual hypersensitivity involving proinflammatory cytokines. There are several case reports indicating an association between Sweet’s syndrome and rheumatoid arthritis (RA). Proinflammatory cytokines are considered to play a vital role in the pathogenesis of both RA and Sweet’s syndrome. Adalimumab works against proinflammatory cytokines and is considered a disease-modifying antirheumatic drug in RA; it is also reported to be effective in refractory Sweet’s syndrome. While adalimumab has been proven to be beneficial in autoimmune disorders and inflammatory conditions, there are also reports of paradoxical development of Sweet’s syndrome with adalimumab. In this report, we present a case of Sweet’s syndrome in a 74-year-old adult patient with a history of seropositive RA who developed Sweet’s syndrome within two months after the initiation of adalimumab therapy.
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Affiliation(s)
- Prodip Paul
- Internal Medicine, Geisinger Community Medical Center, Scranton, USA
| | - Chad P Walker
- Rheumatology, Geisinger Musculoskeletal Institute, Scranton, USA.,Rheumatology, Geisinger Health System, Scranton, USA
| | | | - Dipon Dey
- Epidemiology and Public Health, ZWH Medical Care PC, New York, USA
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3
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Dan H, Yanmei L, Yue X, Xian J. Sweet syndrome associated with malignancies: A retrospective analysis of 25 patients from West China hospital. Dermatol Ther 2020; 33:e13588. [PMID: 32410345 DOI: 10.1111/dth.13588] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 05/12/2020] [Indexed: 02/05/2023]
Abstract
Sweet syndrome (SS), also known as acute febrile neutrophilic dermatosis, is a rare inflammatory disorder characterized by sudden onset of variably tender brightly erythematous-to-violaceous papules, plaques, or nodules. To clarify the frequency, clinical course, therapeutic response, and outcome of Sweet syndrome with malignancy. We conducted a retrospective review of patients diagnosed with SS between 2009 and 2019 with a diagnosis of Sweet syndrome in West China hospital. Records were analyzed for variables, clinical features, etiological factors, laboratory results, and treatment outcomes. The 25 cases under study consisted of 14 (56%) females and 11 (44%) males. Mean age was 52.2 years (range: 4-76 years). Nodules were the commonest lesion presentation (48%), involving mostly the lower limbs (52%). Pain of lesion was identified as the most common symptom (88%), followed by fever (76%) and cough (44%). Among the patients, 52% exhibited the classic form, 48% showed the malignancy-associated form, and 4% exhibited the drug-induced form in the setting of malignancy. Acute myeloid leukemia was the most common malignancy, observed in 5 of 12 patients (41.6%). Anemia (P = .002) was associated with malignancy (Chi-square test).
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Affiliation(s)
- Hao Dan
- Department of Dermatology and Venereology, West China Hospital, SiChuan University, SiChuan, P.R. China
| | - Li Yanmei
- Department of Dermatology and Venereology, West China Hospital, SiChuan University, SiChuan, P.R. China
| | - Xiao Yue
- Department of Dermatology and Venereology, West China Hospital, SiChuan University, SiChuan, P.R. China
| | - Jiang Xian
- Department of Dermatology and Venereology, West China Hospital, SiChuan University, SiChuan, P.R. China
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4
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Heath MS, Ortega-Loayza AG. Insights Into the Pathogenesis of Sweet's Syndrome. Front Immunol 2019; 10:414. [PMID: 30930894 PMCID: PMC6424218 DOI: 10.3389/fimmu.2019.00414] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/15/2019] [Indexed: 12/15/2022] Open
Abstract
Sweet's syndrome, also known as Acute Febrile Neutrophilic Dermatosis, is a rare inflammatory condition. It is considered to be the prototype disease of neutrophilic dermatoses, and presents with acute onset dermal neutrophilic lesions, leukocytosis, and pyrexia. Several variants have been described both clinically and histopathologically. Classifications include classic Sweet's syndrome, malignancy associated, and drug induced. The cellular and molecular mechanisms involved in Sweet's syndrome have been difficult to elucidate due to the large variety of conditions leading to a common clinical presentation. The exact pathogenesis of Sweet's syndrome is unclear; however, new discoveries have shed light on the role of inflammatory signaling, disease induction, and relationship with malignancy. These findings include an improved understanding of inflammasome activation, malignant transformation into dermal infiltrating neutrophils, and genetic contributions. Continued investigations into effective treatments and targeted therapy will benefit patients and improve our molecular understanding of inflammatory diseases, including Sweet's syndrome.
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Affiliation(s)
- Michael S Heath
- Oregon Health and Science University, Department of Dermatology, Portland, OR, United States
| | - Alex G Ortega-Loayza
- Oregon Health and Science University, Department of Dermatology, Portland, OR, United States
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5
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Woo YR, Jung YJ, Kim JS, Kim M, Park YM, Min CK, Kim DW, Park HJ. Cutaneous comorbidities in patients with multiple myeloma: A 10-year retrospective cohort study from a Korean population. Medicine (Baltimore) 2018; 97:e12825. [PMID: 30412074 PMCID: PMC6221631 DOI: 10.1097/md.0000000000012825] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Multiple myeloma (MM) is a common hematologic malignancy characterized by the presence of the clonal proliferation of tumor cells. Studies on cutaneous comorbidities in Asian patients with MM have yet to be conducted.This study aimed to analyze the prevalences, characteristics, overall survivals, and risk factors of various cutaneous comorbidities in patients with MM.A retrospective cohort study using medical records from January 1, 2008, to December 31, 2017, in patients with MM was conducted.Of 1438 patients with MM, 354 patients (24.61%) had one or more cutaneous comorbidities. Among them, herpes zoster infection was found to be the most common cutaneous comorbidity. The development of herpes zoster was found to be a possible candidate for good prognostic factor for overall survival [hazard ratio, 0.62; 95% confidence interval (95% CI), 0.44-0.86], while the occurrence of cutaneous malignant tumor was found to be a possible candidate for poor prognostic factor for overall survival (hazard ratio, 3.13; 95% CI, 1.76-5.56).The development of some cutaneous comorbidities heralds the prognostic importance in patients with MM. A better understanding of the prevalences, clinical characteristics, and risk factors of various cutaneous comorbidities in patients with MM may help clinicians identify the clinical course and prognosis of the disease.
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Affiliation(s)
- Yu Ri Woo
- Department of Dermatology, Yeouido St. Mary's Hospital
| | - Yu Jin Jung
- Department of Dermatology, Yeouido St. Mary's Hospital
| | - Jong Sic Kim
- Department of Dermatology, Yeouido St. Mary's Hospital
| | - Miri Kim
- Department of Dermatology, Yeouido St. Mary's Hospital
| | | | - Chang-Ki Min
- Division of Hematology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong-Wook Kim
- Division of Hematology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Gurnari C, Franceschini L, Anemona L, Passarelli F, Vaccarini S, Pupo L, Provenzano I, Nasso D, Rizzo M, Cantonetti M. Recurrent Sweet's syndrome in a patient with multiple myeloma. Clin Case Rep 2018; 6:1958-1960. [PMID: 30349706 PMCID: PMC6186870 DOI: 10.1002/ccr3.1764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 07/19/2018] [Accepted: 07/20/2018] [Indexed: 02/02/2023] Open
Abstract
We report on a case of Sweet's syndrome associated with multiple myeloma, as harbinger for disease relapse.
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Affiliation(s)
- Carmelo Gurnari
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Luca Franceschini
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Lucia Anemona
- Department of Experimental Medicine and SurgeryAnatomic PathologyFondazione PTV Policlinico Tor VergataTor Vergata UniversityRomeItaly
| | - Francesca Passarelli
- Laboratory of DermatopathologyIstituto Dermopatico dell'Immacolata Istituto di Ricovero e Cura a Carattere ScientificoRomeItaly
| | - Sara Vaccarini
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Livio Pupo
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
| | - Ida Provenzano
- Hematology UnitFondazione PTV Policlinico Tor VergataRomeItaly
| | - Daniela Nasso
- Hematology UnitFondazione PTV Policlinico Tor VergataRomeItaly
| | - Manuela Rizzo
- Hematology UnitFondazione PTV Policlinico Tor VergataRomeItaly
| | - Maria Cantonetti
- Department of Biomedicine and PreventionUniversity of Rome Tor VergataRomeItaly
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7
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Clinicopathologic, immunophenotyping and cytogenetic analysis of Sweet syndrome in Egyptian patients with acute myeloid leukemia. Pathol Res Pract 2017; 213:143-153. [DOI: 10.1016/j.prp.2016.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 09/02/2016] [Accepted: 10/20/2016] [Indexed: 01/26/2023]
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8
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Smyth D, Selwyn J. Acute febrile neutrophilic dermatosis associated with JAK-2 positive myeloproliferative disorder. BMJ Case Rep 2016; 2016:bcr-2016-215289. [PMID: 27118753 DOI: 10.1136/bcr-2016-215289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We present a case of a 77-year-old man with a history of myeloproliferative disorder. He was admitted with a 2-week history of erythaema, swelling and significant pain of the right forearm following a mechanical fall at home, which had caused a skin laceration. During his admission, he developed ongoing intermittent fever and persistently elevated C reactive protein, and total white cell count. Initially, he was treated with antibiotics for suspected cellulitis. However, symptoms continued to progress, making a suitable management plan challenging. Wound swabs, blood cultures and viral PCR did not confirm infection. A punch biopsy of a skin lesion on the forearm was performed. The histology demonstrated a dense infiltrate of neutrophils and neutrophilic debris in keeping with acute febrile neutrophilic dermatosis (Sweet's syndrome). He was treated with oral steroids and after that he had a complete resolution of symptoms. However, he required a period of rehabilitation before returning home.
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Affiliation(s)
- Dean Smyth
- Forth Valley Royal Hospital, Larbert, UK
| | - Jey Selwyn
- Department of Medicine, NHS Forth Valley & University of Edinburgh, Larbert, UK
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Ghoufi L, Ortonne N, Ingen-Housz-Oro S, Barhoumi W, Begon E, Haioun C, Pautas C, Beckerich F, Robin C, Wolkenstein P, Cordonnier C, Chosidow O, Toma A. Histiocytoid Sweet Syndrome Is More Frequently Associated With Myelodysplastic Syndromes Than the Classical Neutrophilic Variant: A Comparative Series of 62 Patients. Medicine (Baltimore) 2016; 95:e3033. [PMID: 27082547 PMCID: PMC4839791 DOI: 10.1097/md.0000000000003033] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Histiocytoid Sweet syndrome (H-SS) is a histological variant of Sweet syndrome (SS) differing from classical neutrophilic SS (N-SS) by a dermal infiltrate mainly composed of lymphocytes and histiocytoid myeloperoxidase-positive cells. We aimed to report a large series of H-SS and compare the frequency and type of hematological malignancies associated to H-SS and N-SS. We included 62 patients with a coding histopathologic diagnosis of SS prospectively registered between 2005 and 2014 in the database of our Department of Pathology. Overall, 22 (35.5%) and 40 (64.5%) patients had a histological diagnosis of H-SS and N-SS, respectively. Median age, sex ratio, and cutaneous lesions were similar in the 2 groups. The frequency of extra-cutaneous manifestations was similar (50% vs 37.5%, P = 0.42). Recurrent forms were significantly more frequent in H-SS than in N-SS patients (21% vs 2.5%, P = 0.01). A hematological malignancy was diagnosed in 22 patients, 12 (55.5%) with H-SS and 10 (25%) with N-SS (P = 0.019). Hematological malignancy was of myeloid origin in 8/22 (36.3%) H-SS and 5/40 (12.5%) N-SS patients (P = 0.02), and of lymphoid origin without myeloid component in 4/22 (18.1%) H-SS and 4/40 (10%) N-SS patients (P = 0.35), respectively. One N-SS patient had a hematological malignancy of mixed (myeloid and lymphoid) phenotype. A myelodysplastic syndrome (MDS) was diagnosed in 7/22 (31.8%) H-SS and 1/40 (2.5%) N-SS patients (P < 0.001). Hematological disease was diagnosed before (in 8 H-SS and 3 N-SS patients) or at the time of the occurrence of the cutaneous lesions (in 1 H-SS and 7 N-SS patients). However, in 3 H-SS patients, all with MDS, cutaneous lesions preceded the hematological disease by ≤6 months. In conclusion, H-SS was associated with MDS in one third of patients but also with lymphoid malignancies, and cutaneous lesions could precede the hematological diagnosis in patients with MDS. A complete hematological assessment is mandatory at diagnosis, and monitoring blood cell counts should be recommended for at least 6 months after the diagnosis of H-SS.
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Affiliation(s)
- Lisa Ghoufi
- From the Department of Dermatology, Assistance-Publique-Hopitaux-de-Paris (AP-HP), Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil, France (LG, SI-HO, PW, OC); Université Paris-Est Créteil (UPEC) (NO, CH, PW, CC, OC); UMR-S 955, Faculté de Médecine, Hopital Henri Mondor, Créteil, France (NO); Department of Pathology, AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil, France (NO); Department of Hematology, AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil, France (WB, CP, FB, CR, CC, AT); Department of Dermatology, Centre Hospitalier René Dubos, Pontoise, France (EB); and Lymphoid Malignancies Unit, AP-HP, Groupe Hospitalier Henri Mondor-Albert Chenevier, Créteil, France (CH)
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Szalat R, Monsel G, Le Goff W, Battistella M, Bengouffa D, Schlageter MH, Bouaziz JD, Arnulf B, Vignon M, Lesnik P, Saussine A, Malphettes M, Lazareth A, Vignon-Pennamen MD, Bagot M, Brouet JC, Fermand JP, Rybojad M, Asli B. The spectrum of neutrophilic dermatoses associated with monoclonal gammopathy: Association with IgA isotype and inflammatory profile. J Am Acad Dermatol 2015; 73:809-20. [DOI: 10.1016/j.jaad.2015.07.031] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 07/21/2015] [Accepted: 07/26/2015] [Indexed: 01/31/2023]
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11
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[Dermatological manifestations of monoclonal gammopathies: contribution of cutaneous histopathology]. Ann Pathol 2015; 35:281-93. [PMID: 26188671 DOI: 10.1016/j.annpat.2015.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 05/06/2015] [Indexed: 12/19/2022]
Abstract
Skin manifestations associated with monoclonal gammapathy are common and can present with various clinical and pathological aspects. They can be the first events leading to the diagnosis of monoclonal gammapathy. They may be present either as specific lesions, including lymphoplasmacytic or pure plasma cell neoplastic infiltrates and monoclonal immunoglobulin deposits, or as non-specific dermatitis, such as leukocytoclastic vasculitis, neutrophilic dermatoses, mucinoses or xanthomatosis, giving little clues for the diagnosis of the underlying disease.
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12
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13
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[Skin manifestations of monoclonal gammopathies]. Rev Med Interne 2013; 35:28-38. [PMID: 24070793 DOI: 10.1016/j.revmed.2013.08.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 08/19/2013] [Accepted: 08/21/2013] [Indexed: 01/01/2023]
Abstract
Whatever their aetiology, monoclonal gammopathies can be associated to several clinical features. Mechanisms are various and sometimes unknown. Skin is frequently involved and may represent a challenging diagnosis. Indeed, skin manifestations are either the presenting features and isolated, or at the background of a systemic syndrome. Our objective was to review the various skin manifestations that have been associated with monoclonal gammopathies.
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Sweet syndrome: clinical presentation, associations, and response to treatment in 77 patients. J Am Acad Dermatol 2013; 69:557-64. [PMID: 23891394 DOI: 10.1016/j.jaad.2013.06.023] [Citation(s) in RCA: 128] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 06/12/2013] [Accepted: 06/13/2013] [Indexed: 01/09/2023]
Abstract
BACKGROUND Sweet syndrome is a neutrophilic dermatosis with cutaneous tender lesions that can be associated with malignancies, infections, systemic inflammatory disorders, and medications. Although numerous studies have described Sweet syndrome, few studies have systematically investigated Sweet syndrome. OBJECTIVE We sought to describe characteristics and treatments of patients with Sweet syndrome and evaluate clinical differences depending on the underlying cause. METHODS A retrospective study was conducted to identify patients with Sweet syndrome evaluated at Mayo Clinic from 1992 to 2010. RESULTS Of 77 patients with Sweet syndrome (mean age of onset 57 years), 43 (56%) were male. Eighteen patients (23%) reported a preceding infection. A total of 41 (53%) patients were classified as having classic Sweet syndrome, 27 (35%) patients had malignancy-associated Sweet syndrome, and in 9 (12%) patients drug-induced Sweet syndrome was considered. In all, 21 patients had a hematologic malignancy or myeloproliferative/myelodysplastic disorder, whereas 6 patients had solid tumors. The mean hemoglobin level, in both male and female patients (P < .0443 and P < .0035, respectively), was significantly lower in malignancy-associated versus classic and drug-induced Sweet syndrome. Systemic corticosteroids were the most frequently used treatment (70%). LIMITATIONS This is a retrospective study and represents patients from a single academic center. CONCLUSIONS Sweet syndrome is a distinctive disorder with certain clinical and histologic characteristics, which usually has a complete response to systemic corticosteroids. It is important to evaluate Sweet syndrome patients who have laboratory evidence of anemia for an underlying malignancy.
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15
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Paraneoplastic Scleroderma-Like Tissue Reactions in the Setting of an Underlying Plasma Cell Dyscrasia. Am J Dermatopathol 2013; 35:561-8. [DOI: 10.1097/dad.0b013e31827adbc8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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16
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Mathieu S, Soubrier M, Tournadre A, Dubost JJ. Neutrophilic dermatosis of the dorsal hands during thalidomide treatment. Int J Dermatol 2013; 53:1133-5. [DOI: 10.1111/j.1365-4632.2012.05714.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Sylvain Mathieu
- Department of Rheumatology, Gabriel Montpied Teaching Hospital; Clermont 1 University; Clermont-Ferrand France
| | - Martin Soubrier
- Department of Rheumatology, Gabriel Montpied Teaching Hospital; Clermont 1 University; Clermont-Ferrand France
| | - Anne Tournadre
- Department of Rheumatology, Gabriel Montpied Teaching Hospital; Clermont 1 University; Clermont-Ferrand France
| | - Jean-Jacques Dubost
- Department of Rheumatology, Gabriel Montpied Teaching Hospital; Clermont 1 University; Clermont-Ferrand France
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17
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Thieu KP, Rosenbach M, Xu X, Kist JM. Neutrophilic dermatosis complicating lenalidomide therapy. J Am Acad Dermatol 2009; 61:709-10. [DOI: 10.1016/j.jaad.2008.12.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2008] [Revised: 11/24/2008] [Accepted: 12/04/2008] [Indexed: 11/17/2022]
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18
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Tanguy-Schmidt A, Avenel-Audran M, Croué A, Lissandre S, Dib M, Zidane-Marinnes M, Moles MP, Hunault-Berger M. Dermatose neutrophilique aiguë induite par le bortezomib. Ann Dermatol Venereol 2009; 136:443-6. [DOI: 10.1016/j.annder.2008.11.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Accepted: 11/21/2008] [Indexed: 12/19/2022]
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19
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Buck T, González LM, Lambert WC, Schwartz RA. Sweet's syndrome with hematologic disorders: a review and reappraisal. Int J Dermatol 2008; 47:775-82. [PMID: 18717854 DOI: 10.1111/j.1365-4632.2008.03859.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
- Thomas Buck
- Departments of Dermatology and Pathology, New Jersey Medical School, Newark, New Jersey, USA
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Rongioletti F, Patterson JW, Rebora A. The histological and pathogenetic spectrum of cutaneous disease in monoclonal gammopathies. J Cutan Pathol 2008; 35:705-21. [DOI: 10.1111/j.1600-0560.2007.00884.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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21
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Cohen PR. Sweet's syndrome--a comprehensive review of an acute febrile neutrophilic dermatosis. Orphanet J Rare Dis 2007; 2:34. [PMID: 17655751 PMCID: PMC1963326 DOI: 10.1186/1750-1172-2-34] [Citation(s) in RCA: 490] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Accepted: 07/26/2007] [Indexed: 01/19/2023] Open
Abstract
Sweet's syndrome (the eponym for acute febrile neutrophilic dermatosis) is characterized by a constellation of clinical symptoms, physical features, and pathologic findings which include fever, neutrophilia, tender erythematous skin lesions (papules, nodules, and plaques), and a diffuse infiltrate consisting predominantly of mature neutrophils that are typically located in the upper dermis. Several hundreds cases of Sweet's syndrome have been published. Sweet's syndrome presents in three clinical settings: classical (or idiopathic), malignancy-associated, and drug-induced. Classical Sweet's syndrome (CSS) usually presents in women between the age of 30 to 50 years, it is often preceded by an upper respiratory tract infection and may be associated with inflammatory bowel disease and pregnancy. Approximately one-third of patients with CSS experience recurrence of the dermatosis. The malignancy-associated Sweet's syndrome (MASS) can occur as a paraneoplastic syndrome in patients with an established cancer or individuals whose Sweet's syndrome-related hematologic dyscrasia or solid tumor was previously undiscovered; MASS is most commonly related to acute myelogenous leukemia. The dermatosis can precede, follow, or appear concurrent with the diagnosis of the patient's cancer. Hence, MASS can be the cutaneous harbinger of either an undiagnosed visceral malignancy in a previously cancer-free individual or an unsuspected cancer recurrence in an oncology patient. Drug-induced Sweet's syndrome (DISS) most commonly occurs in patients who have been treated with granulocyte-colony stimulating factor, however, other medications may also be associated with DISS. The pathogenesis of Sweet's syndrome may be multifactorial and still remains to be definitively established. Clinical and laboratory evidence suggests that cytokines have an etiologic role. Systemic corticosteroids are the therapeutic gold standard for Sweet's syndrome. After initiation of treatment with systemic corticosteroids, there is a prompt response consisting of dramatic improvement of both the dermatosis-related symptoms and skin lesions. Topical application of high potency corticosteroids or intralesional corticosteroids may be efficacious for treating localized lesions. Other first-line oral systemic agents are potassium iodide and colchicine. Second-line oral systemic agents include indomethacin, clofazimine, cyclosporine, and dapsone. The symptoms and lesions of Sweet's syndrome may resolved spontaneously, without any therapeutic intervention; however, recurrence may follow either spontaneous remission or therapy-induced clinical resolution.
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Affiliation(s)
- Philip R Cohen
- University of Houston Health Center, Houston, Texas, USA.
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Lachman RS. S. TAYBI AND LACHMAN'S RADIOLOGY OF SYNDROMES, METABOLIC DISORDERS AND SKELETAL DYSPLASIAS 2007. [PMCID: PMC7315357 DOI: 10.1016/b978-0-323-01931-6.50027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Franco M, Giusti C, Malieni D, Ferrario D, Galimberti G, Hidalgo Parra I, Kowalczuk A, Galimberti R. Síndrome de Sweet asociado a neoplasias. An Bras Dermatol 2006. [DOI: 10.1590/s0365-05962006000500011] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
El síndrome de Sweet fue descrito en el año 1964 por Robert Douglas Sweet, como una entidad a la cual denominó dermatosis neutrofílica febril y aguda. Se caracteriza por cinco rasgos principales: 1) aparición brusca de placas eritemato-dolorosas en cara, cuello y extremidades; 2) fiebre; 3) leucocitosis polimorfonuclear; 4) denso infiltrado dérmico a predominio neutrofilico; 5) rápida respuesta al tratamiento esteroideo. Se puede clasificar en cinco grupos: idiopático, parainflamatorio, paraneoplásico, secundario a drogas y asociado a embarazo. En el 20% de los casos se asocia a enfermedades malignas, representando las hematológicas el 85% y los tumores sólidos el 15% restante. Se presenta una serie de siete casos de síndrome de Sweet asociado a neoplasias, diagnosticados durante el período 2002-2006, de los cuales seis correspondieron a enfermedades oncohematológicas y el restante a tumores sólidos. Como comentario de dicha casuística, se hace hincapié en la importancia del diagnóstico de este síndrome, debido a que puede anunciar la recaída del tumor o la progresión de la enfermedad de base. De esta manera, mediante el uso de métodos de diagnóstico y tratamiento oportunos, se lograría mejorar la calida de vida de estos pacientes. También debe tenerse en cuenta, que los pacientes oncológicos reciben múltiples medicaciones (factor estimulante de colonias), que pueden estar implicadas en la aparición de esta entidad, debiendo ser las mismas descartadas como posibles causas.
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Abecassis S, Ingen-Housz-Oro S, Cavelier-Balloy B, Arnulf B, Bachelez H, Dubertret L. [Particular histological features of a case of Sweet's syndrome induced by G-CSF]. Ann Dermatol Venereol 2005; 131:369-72. [PMID: 15258512 DOI: 10.1016/s0151-9638(04)93617-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Sweet's syndrome may occur during medullar aplasia, especially after treatment with exogenous growth factors such as G-CSF. In this context, Sweet's syndrome presents particular histological features that we detail in this observation. CASE REPORT A 50 year-old man was treated for multiple myeloma with a mobilizating chemotherapy prior to autologous stem cell transplantation. Four days after the onset of G-CSF, he presented with a febrile generalized eruption of erythematous infiltrated lesions. Histological examination of a skin biopsy showed a neutrophilic infiltrate associated with atypical xanthomized histiocytes and vascular hyperplasia with marked endothelial turgescence. Treatment with a short cause of oral corticosteroids was efficient. DISCUSSION The classical histological features of Sweet's syndrome consist in a dermal neutrophilic infiltrate with edema. In our patient, we noticed the presence of atypical histiocytes among the dermal neutrophilic infiltrate. These histiocytes are described in maculo-papular eruptions induced by G-CSF, and should not be confused with a malignant infiltrate associated with a hemopathy. Vascular hyperplasia may be related to the angiogenic properties of G-CSF. Knowledge of these histological features would enable clinicians and histologists to recognize the appropriate diagnosis.
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Affiliation(s)
- S Abecassis
- Service de Dermatologie I, Hôpital Saint-Louis, 1, avenue Claude Vellefaux, 75010 Paris
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